Abstract Number: PB1307
Meeting: ISTH 2021 Congress
Background: Pregnancy and the postpartum period are risk factors for developing venous thromboembolic disease, which is an important cause of morbidity in this population. Since peroral medications are contraindicated due to possible fetal complications, the drug of choice is low molecular weight heparin (LMWH). There are some differences according to different guidelines in LMWH dosing especially around the delivery when the suggestions are not so clear. There is also scarce data about the long-term outcome.
Aims: We wanted to assess the efficacy and safety of our VTE treatment scheme during pregnancy and postpartum and asses also the long-term outcome in patients with deep venous thrombosis (DVT).
Methods: All pregnant patients on treatment due to previous or VTE in current pregnancy treated in our clinics from 2010 to 2019 were included. An initial dose of LMWH was adjusted according to the body weight and increased when body weight went up. Some adjustments were done also according to anti-Xa testing. Treatment was stopped the day before delivery when the patient got only half dose and started when vaginal delivery after 12, and after cesarean section after 8 hours, then therapeutic dose every 24 hours till the end of the 6th week after delivery. Recurrent VTEs and all bleedings were looked for and long-term efficacy in patients with deep venous thrombosis (DVT) was assessed by Villalta score and ultrasound investigation 5-12 months after delivery.
Results: We included 116 women. The outcomes – recurrent VTEs, bleedings, and incidence of a post-thrombotic syndrome are shown in table 1.
Table 1. Outcomes in treated patients.
|Recurrent VTE on treatment||N (%)|
|Bleedings on treatment|
|Minor during pregnancy||6 (5.2)|
|Minor clinically important during pregnancy||3 (2.6)|
|Major peripartum+*||1 (0.9)|
|Major postpartum*||1 (0.9)|
|Postthrombotic syndrome** in 95 patients with DVT||6 (6.3)|
*- gynecological cause by a gynecologist, ** – Villalta score >5
Conclusions: In our study the incidence of recurrent VTEs and bleedings was low. Only 6 women reported the development of the postthrombotic syndrome. We believe that our therapeutic regime is effective and safe.
To cite this abstract in AMA style:Stražišar Š, Kozak M. Outcomes of Treatment of Thromboembolic Disease during Pregnancy and Postpartum – Single-center Experience [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/outcomes-of-treatment-of-thromboembolic-disease-during-pregnancy-and-postpartum-single-center-experience/. Accessed December 3, 2021.
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